In this application we propose to evaluate an usually high uterine cervical cancer incidence in the Republic of Panama. Panama not only has the highest reported cervical cancer incidence in the world but also demonstrates geographic clustering and a marked shift in age specific incidence (most invasive cervical cancer occurs in 20-39 year old women). We plan to evaluate this by first recording all cervical cancer cases which occurred between 1974-1977, in a standardized national cancer registry. We will then do a seroepidemiologic case-control study comparing socioeconomic, sexual and herpes group virus risk factors in cases and controls. In addition we plan to measure other variables which might account for the unique aspects of cervical cancer seen in Panama. Lastly we will evaluate the effects of the existing Pap smear program and collaborate in initiation of a more intensive screening program.